Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part D Diagnosis
Chapter 17.1. Spectrum Bias
Gordon Guyatt, Victor Montori, Peter Wyer, Thomas Newman, Sheri Keitz
Sections:
Choosing the Wrong Patients Will Bias Estimates of the Usefulness of a Diagnostic Test, Target-Positive Patients With Severe Disease and Target-Negative Without Suspected Disease Are the Wrong Patients, Distributions of Test Results Illustrate the Spectrum Problem, The Right Population Includes Only Patients With Diagnostic Uncertainty, Distribution of Test Results Helps Understanding of Likelihood Ratios, Spectrum, Not Disease Prevalence, Determines Test Properties, Prevalence (or Pretest Probability) Does Influence Posttest Probability, Likelihood Ratios Should Reflect Appropriate Spectrums of Target-Positive and Target-Negative Patients, References
Topics Discussed:
bias (conflict of interest), bias, epidemiologic, conduct considerations, criterion standard comparisons (diagnostic tests), diagnostic process, diagnostic techniques and procedures, spectrum bias
Excerpt:
"For clinicians to appropriately use diagnostic tests in clinical
practice, they need to know the tests' power to
distinguish between those who have the target
condition and those who do not. As we pointed out in Chapter 16, Diagnostic Tests, if investigators
choose clinically inappropriate populations for their study of a
diagnostic test (introducing what is sometimes called spectrum
bias), the results may seriously mislead clinicians...."
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